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First of all, if your child hits his head as a result of a major collision or a fall from any serious distance — he falls down the stairs or gets whacked with a bat or ball, for example — you should talk with his doctor. She'll want to know the details of the accident and whether your child lost consciousness, is excessively irritable or crying, or is vomiting or lethargic. She may tell you to bring him to the office or to the emergency room. If your child has had a little bump, though — he topples off his tricycle or clunks heads with his feisty sibling — you'll just want to keep an eye on him for a while.
Many parents believe they need to keep their child awake after a serious fall to prevent a coma, but this is an old wives' tale with no basis in reality. Actually, having your child take a restorative nap after an emotional trauma like a scary fall can be comforting.
Of course, it's still important to watch your child closely for signs of problems, such as severe headache, vomiting, changes in speech, or difficulty with walking or coordination. It's even a good idea to wake your child up twice each night during the first two nights after a fall in which he hits his head, just to make sure you can. If he's alert when you wake him up (well, as alert as a child who's been awakened can be), then it's unlikely that the fall has caused any evolving problems, like bleeding in the brain.
If your child seems overly groggy or lethargic, or if you're worried for any reason, trust your instincts and call his doctor for advice. She may want to give him a quick checkup. If at any point you're unable to wake your child, take him to the emergency room.